Acute and severe diarrhea may occur in many circumstances. However clinically significant diarrhea is commonly seen during cancer chemotherapy and during the acute phase of withdrawal in persons addicted to narcotics such as heroin and methadone.
Newer techniques for treating narcotic addiction entail purposefully precipitating an acute withdrawal reaction by the administration of narcotic antagonist drugs such as naloxone, naltrexone or nalmefene. For example, the '081 application, herein incorporated by reference, discloses rapid detoxification methods using the opioid antagonist nalmefene. As disclosed in the '081 application, the addicted patient is given a 1.0 mg intravenous bolus of nalmefene, followed by an intravenous infusion of 1.0 mg nalmefene some time after the initial bolus. Approximately 10 hours after the nalmefene is infused, another 1.0 mg dose of parenteral nalmefene may be given, such as by subcutaneous or intramuscular injection. Approximately 10 hours later a final intramuscular or subcutaneous bolus dose of nalmefene can be given, thereby completing a cycle of parenteral administration of nalmefene totaling approximately 4.0 mg over a span of time approximately 24 hours.
Alternatively, a loading dose of from about 0.5-1.5 mg to no more than about 1.5-2.0 mg is given, followed by slow intravenous infusion at a rate equivalent to 2.0-3.5 mg/day. This dosage regimen is convenient if the patient is to receive intravenous hydration for treatment of nausea and/or diarrhea as may sometimes be associated with withdrawal from opioids.
A method for treating the acute and severe diarrhea typically precipitated by rapid detoxification procedures is to administer the somatostatin analogue octreotide. While octreotide has proven effective in treating clinically significant diarrhea during rapid detoxification, it is associated with an unacceptable incidence of bradycardia, which in some instances has been so severe as to be life threatening.
It is, accordingly, an object of the invention to provide an effective method for treating acute and severe diarrhea.
It is a further object of the invention to provide such a method which reduces the incidence of life threatening bradycardia.
It is a still further object of the invention to provide a method of rapid narcotic detoxification which safely and effectively treats the acute and severe diarrhea typically accompanying acute withdrawal.